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131.
132.
KM Kanal NJ Hangiandreou AM Sykes HE Eklund PA Araoz JA Leon BJ Erickson 《Journal of digital imaging》2001,14(1):30-37
The aims of this work were to measure the accuracy of one continuous speech recognition product and dependence on the speaker's gender and status as a native or nonnative English speaker, and evaluate the product's potential for routine use in transcribing radiology reports. IBM MedSpeak/Radiology software, version 1.1 was evaluated by 6 speakers. Two were nonnative English speakers, and 3 were men. Each speaker dictated a set of 12 reports. The reports included neurologic and body imaging examinations performed with 6 different modalities. The dictated and original report texts were compared, and error rates for overall, significant, and subtle significant errors were computed. Error rate dependence on modality, native English speaker status, and gender were evaluated by performing ttests. The overall error rate was 10.3 +/- 3.3%. No difference in accuracy between men and women was found; however, significant differences were seen for overall and significant errors when comparing native and nonnative English speakers (P = .009 and P = .008, respectively). The speech recognition software is approximately 90% accurate, and while practical implementation issues (rather than accuracy) currently limit routine use of this product throughout a radiology practice, application in niche areas such as the emergency room currently is being pursued. This methodology provides a convenient way to compare the initial accuracy of different speech recognition products, and changes in accuracy over time, in a detailed and sensitive manner. 相似文献
133.
R. Varghese M. Ch. K. Shivaprakasha M.Ch. SR Mohanty M.Ch. KA Hassan MS R Coelho M.Ch. KS Murthy M.Ch. KM Cherian FRACS 《Indian Journal of Thoracic and Cardiovascular Surgery》2001,17(2):82-85
Background Though the use of median stermotomy has been fairly standardized for the approach to the heart and great vessels, since the
advent of cosmetically appealing incisions, thoracotomy has come to be a justifiable alternative incision. This paper presents
our experience with this approach and the advantages over the conventional approach as well as over other incisions for the
correction of intra-cardiac anomalies.
Methods 93 patients underwent open cardiac procedures using the posterior thoracotomy approach since June 1997 to December 2000. There
were 69 patients with ostium secundum atrial septal defects and 12 patients with sinus venous defects. Other anomalies included
perimembranous ventricular septal defects in 3 patients, partial atrioventricular septal defects in 3 patients and transitional
atrioventricular septal defects in 2 patients. Besides these, one patient each underwent atrial septectomy with right modified
Blaloc—Taussing shunt and correction of hemianomalous pulmonary venous connection with intact atrial septum using this approach.
The median age of the patients was 8 years with a range of 10 months to 41 years. 10 patients were males.
Results The median operation time (skin to skin) was 236 minutes. Median bypass times and aortic cross clamp times were 63 minutes
and 31.5 minutes respectively. The median ICU stay was 25.2 hours. There were no significant immediate post operative complications
requiring intervention in any patient. The mean chest drainage was 80 ml per 24 hours. One patient had a superficial wound
dehiscence which healed with daily dressings One patient had atelectasis of the right upper lobe which recovered with chest
physiotherapy. All patients are on regular follow up to assess the status of their scars. One patients developed a mass on
the right atrial free wall following closure of atrial septal defect one year earlier and the underwent reoperation for removal
of the mass. Patients on follow up were interrogated and all were satisfied with the cosmesis of their scars. None of the
patients had any physical disability due to their scars.
Conclusions The limited posterior thoracotomy incision offers a cosmetically attractive approach to the heart in selected patients. The
approach is easy and the techniques reproducible. The technique carries with it no additional risk and has the advantage of
not interfering with future development of the breast in young pre pubertal girls. 相似文献
134.
过去10至15年间,关于对早产儿必须提供适宜的环境的论点,已被众多的研究者反复论证.通过减少有害的刺激如光、声、人员往来,并且给予适当的体位和护理,早产儿护理的效果显著好转. 相似文献
135.
136.
A Lally D Casabonne T Waterboer B Imko‐Walczuk KM Michael M Pawlita R Newton F Wojnarowska 《Journal of the European Academy of Dermatology and Venereology》2010,24(3):302-307
Background Renal transplant recipients (RTR) have a well recognized increased risk of cutaneous malignancy. A clinical observation that RTR with skin cancer often had multiple seborrhoeic warts prompted an investigation in RTR into the relationship between seborrhoeic warts and skin cancer and an exploration into potential risk factors for seborrhoeic warts in this population, including infection with human papillomavirus (HPV). Methods This was a case control study involving 308 RTR. Clinical examinations identified seborrhoeic warts. Histological records reviewed to look for evidence of prior cutaneous malignancy. Seroprevalence of antibodies to 34 different HPV types tested using multiplex serology. Odds ratios (OR) calculated using unconditional logistic regression analysis to look for associations between skin cancer, HPV infection and seborrhoeic warts, controlling for potential confounding factors of gender, age and time since transplantation. Results Seborrhoeic warts were associated with non‐melanoma skin cancer [OR = 3.7; 95% confidence intervals (CI) ranging from 1.6–8.9; P = 0.002] when confounding factors of gender, age and time since transplantation were controlled for. There was also an association between seborrhoeic warts and viral warts (OR = 3.0, CI: 1.6–5.4; P < 0.0001), but no association between seborrhoeic warts and infection with single or multiple HPV types. Conclusions Seborrhoeic warts are associated with cutaneous malignancy, but not with any of the HPV types tested. The reasons for this association are unclear. RTR with multiple seborrhoeic warts may require more regular cutaneous examination to monitor for early signs of skin cancer. 相似文献
137.
Matthias Hoben Dr rer medic David B. Hogan MD Jeffrey W. Poss PhD Andrea Gruneir PhD Kim McGrail PhD Lauren E. Griffith PhD Stephanie A. Chamberlain PhD Carole A. Estabrooks PhD Colleen J. Maxwell PhD 《Journal of the American Geriatrics Society》2023,71(11):3467-3479
Background
While assisted living (AL) and nursing home (NHs) residents in share vulnerabilities, AL provides fewer staffing resources and services. Research has largely neglected AL, especially during the COVID-19 pandemic. Our study compared trends of practice-sensitive, risk-adjusted quality indicators between AL and NHs, and changes in these trends after the start of the pandemic.Methods
This repeated cross-sectional study used population-based resident data in Alberta, Canada. Using Resident Assessment Instrument data (01/2017–12/2021), we created quarterly cohorts, using each resident's latest assessment in each quarter. We applied validated inclusion/exclusion criteria and risk-adjustments to create nine quality indicators and their 95% confidence intervals (CIs): potentially inappropriate antipsychotic use, pain, depressive symptoms, total dependency in late-loss activities of daily living, physical restraint use, pressure ulcers, delirium, weight loss, urinary tract infections. Run charts compared quality indicators between AL and NHs over time and segmented regressions assessed whether these trends changed after the start of the pandemic.Results
Quarterly samples included 2015–2710 AL residents and 12,881–13,807 NH residents. Antipsychotic use (21%–26%), pain (20%–24%), and depressive symptoms (17%–25%) were most common in AL. In NHs, they were physical dependency (33%–36%), depressive symptoms (26%–32%), and antipsychotic use (17%–22%). Antipsychotic use and pain were consistently higher in AL. Depressive symptoms, physical dependency, physical restraint use, delirium, weight loss were consistently lower in AL. The most notable segmented regression findings were an increase in antipsychotic use during the pandemic in both settings (AL: change in slope = 0.6% [95% CI: 0.1%–1.0%], p = 0.0140; NHs: change in slope = 0.4% [95% CI: 0.3%–0.5%], p < 0.0001), and an increase in physical dependency in AL only (change in slope = 0.5% [95% CI: 0.1%–0.8%], p = 0.0222).Conclusions
QIs differed significantly between AL and NHs before and during the pandemic. Any changes implemented to address deficiencies in either setting need to account for these differences and require monitoring to assess their impact. 相似文献138.
139.
Modeling the growth of Yersinia enterocolitica in donated blood 总被引:4,自引:0,他引:4
BACKGROUND: Sepsis and death subsequent to the transfusion of blood containing Yersinia enterocolitica is an increasing problem. The organisms probably originate from bacteremia in the donor and can subsequently multiply at low temperature. STUDY DESIGN AND METHODS: Reported here are experiments with a strain of Y. enterocolitica associated with a case of transfusion-associated bacteremia. RESULTS: It was found that the rapid early killing of Y. enterocolitica injected into donated blood does not require viable phagocytes and can be explained by complement-mediated killing. Complement resistance in Y. enterocolitica is known to be plasmid-coded. It is expressed at 37 degrees C, but not at 20 degrees C, and is favored by calcium-deficient culture media. Y. enterocolitica organisms induced to express complement resistance were still killed in donated blood, though the initial rate was slower. Such organisms multiplied in plasma at 37 degrees C, but were killed after 6 hours of incubation at 20 degrees C, presumably because complement resistance genes are switched off at this temperature. CONCLUSION: This experiment is thought to reflect the natural history of Y. enterocolitica contamination of blood, in which complement-resistant organisms in the donor blood encounter lower temperatures after donation. These observations suggest that the practice of plasma depletion may have contributed to the increased incidence of mortality due to Y. enterocolitica contamination of donated blood. 相似文献
140.